•
Chris Clark, Cinema St. Louis
•
Steve Franklin, MSW, LCSW
•
Michael Uthoff, Dance St. Louis
SteveFranklinMSW@JUNO.com

• Natalie Portman as Nina Sayer
• Vincent Cassel as Thomas Leroy
• Mila Kunis as Lily
• Barbara Hershey as Erica Sayers
• Winona Ryder as Beth Macintyre

• Directed by Darren Aronofsky
• Other Oscar nominations:
– Cinematography
– Editing
– Best picture

for
• strong sexual content
• disturbing violent images
• language and
• some drug use

• It’s just a movie…….
• What is real?

• Simply the price of great art…
• Or psychopathology?

The ability to build a construct of "reality" with other people, while still retaining the capacity for autonomous perception and judgment;

balancing our need for private self-experience against the equally-important need to share experience with the important people in our lives.
... Alex Lerman http://www.dailykos.com/user/Alex%20Lerman

The ability to build a construct of "reality" with other people, while still retaining the capacity for autonomous perception and judgment; balancing our need for private self-experience against the equally-important need to share experience with the important people in our lives. ... Alex Lerman http://www.dailykos.com/user/Alex%20Lerman

about specific diagnoses possibly depicted in “The Black Swan”

• delusions
• hallucinations
• disorganized speech
• grossly disorganized or catatonic behavior
• negative symptoms
(reduced emotional expression/speech/ motivation )

may be associated with
Schizophrenia or many other causes

Anorexia Nervosa

• Body weight < 85% of normal range
• Intense fear of gaining weight
• Disturbance in the way in which one's body weight or shape is experienced
• Amenorrhea
• “Restricting” or “Binge-Eating/Purging”

• Childhood History of Abuse?
• Ongoing unhealthy parental relationship?
• Incomplete ego development?

• cognition
• affectivity
• interpersonal functioning
• impulse control
• --in a range of personal/social situations
• --significant distress or impairment in
• --social/occupational/important areas

• unstable relationships, tending to idealize or devalue
• unstable sense of self
• inconsistent, reactive moods
• feelings of emptiness

• an intense fear of abandonment
• suicidal or self-mutilating behavior
• often intense and sudden anger
• self damaging impulsivity
• stress related paranoia or dissociation

• Preoccupation with lists, details
• Perfectionism interferes with task completion
• Work focus out of balance with leisure/friendships
• Overconscientious/inflexible

• Unable to discard objects
• Difficulty delegating
• Miserly spending style
• Rigid, stubborn

• Obsessions:
• Intrusive, distressing, recurrent thoughts, impulses, images
--(not simply real life worries)
--that a person tries to stop
--that are recognized as self generated

• or Compulsions:
• repetitive behaviors driven to perform
• aimed at reducing stress or
• unrealistically preventing dreaded event
• Self-recognized as unreasonable
• Interfere with life,
• are time consuming (>1 hour), or distressing

• Repression of “dark impulses”
• Shadow
May disguise or deny

B lack S wan

• Director leaves it unclear
• Clients and therapists may also be unclear

• What do we expect of performers/artists/athletes?
• Perfectionism?
• Dissociation to avoid pain?
• Necessity to have ballet body type?

The ability to build a construct of "reality" with other people while still retaining the capacity for autonomous perception and judgment; balancing our need for private self-experience against the equally-important need to share experience with the important people in our lives. ...

Anorexia Nervosa

• Body weight < 85% of normal range
• Intense fear of gaining weight
• Disturbance in the way in which one's body weight or shape is experienced
• Amenorrhea
• “Restricting” or “Binge-Eating/Purging”

• inner experience and behavior that deviates markedly (2 or more areas):
• Cognition, affectivity, interpersonal functioning,impulse control
• --range of personal and social situations
• --clinically significant distress/impairment
• --social/occupational/other functioning.

• Preoccupation with lists, details
• Perfectionism interferes with task completion
• Work focus out of balance with leisure/friendships
• Overconscientious/inflexible
• Unable to discard objects
• Difficulty delegating
• Miserly spending style
• Rigid, stubborn

• unstable relationships, idealize or devalue
• unstable sense of self
• inconsistent, reactive moods
• feelings of emptiness
• an intense fear of abandonment
• suicidal or self-mutilating behavior
• often intense and sudden anger
• self damaging impulsivity
• stress related paranoia or dissociation

• Obsessions: Intrusive, distressing, recurrent thoughts, impulses, images that a person tries to stop,that are recognized as self generated
• or Compulsions: repetitive behaviors driven to perform aimed at reducing stress or unrealistically preventing dreaded event
Self recognized as unreasonable; Interfere with life… time consuming … distressing

• Childhood History of Abuse?
• Ongoing unhealthy parental relationship?
• Incomplete ego development?

• Repression of “dark impulses”
• Shadow
Essence of the Swan Lake story

• CSP (Compulsive Skin Picking or
Chronic Skin Picking).
• impulse control disorder
• body dysmorphic disorder

• delusions
• hallucinations
• disorganized speech
• grossly disorganized or catatonic behavior
• negative symptoms (reduced emotional expression/ speech/motivation)

• Psychosis, plus
• Social/occupational dysfunction
• 6 months of disturbance, 1 month of symptoms

• Electrolyte imbalance
From purging?
• Drug Induced
Ecstasy?